Clinical study of microvascular invasion on prognosis of recipients after liver transplantation for liver cancer / 器官移植

Objective To evaluate the effect of microvascular invasion (MVI) on prognosis of recipients after liver transplantation for primary liver cancer (liver cancer). Methods Clinical data of 177 recipients after liver transplantation for liver cancer were retrospectively analyzed. All patients were divided into the MVI-positive group (n=64) and MVI-negative group (n=113) according to postoperative pathological examination results. Clinical data were statistically compared of all recipients between the negative and positive MVI groups. The prognosis and risk factors of liver transplantation recipients for liver cancer were analyzed. Results Among 177 recipients, 64 cases (36.2%) were positive for MVI and 113 (63.8%) negative for MVI. Compared with the MVI-negative recipients, MVI-positive recipients had significantly lower degree of tumor differentiation, higher preoperative alpha-fetaprotein (AFP) level, larger maximal tumor diameter, a larger quantity of tumors, more satellite lesions and more recipients who did not meet the Milan criteria (all P < 0.05). The 1-, 3- and 5-year overall survival (OS) and recurrence-free survival (RFS) of recipients after liver transplantation for liver cancer were 80.2%, 62.1%, 58.5% and 66.3%, 57.5%, 51.2%, respectively. The 1-, 3- and 5-year OS and RFS of MVI-positive recipients were 70%, 39%, 35% and 53%, 39%, 33%, significantly lower than 86%, 75%, 72% and 73%, 68%, 63% of their counterparts negative for MVI (all P < 0.05). Cox regression analysis showed that the maximal tumor diameter >8 cm, preoperative AFP level ≥20 ng/mL, low degree of tumor differentiation and positive MVI were the independent risk factors for OS of recipients after liver transplantation for liver cancer (all P < 0.05). Positive MVI, low degree of tumor differentiation and preoperative down-staging failure were the independent risk factors for RFS of recipients after liver transplantation for liver cancer (all P < 0.05). Conclusions MVI is of significant clinical value in predicting clinical prognosis of recipients after liver transplantation for liver cancer.

Expression and clinical significance of MAGE-C1 in breast cancer tissues / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To investigate the expression of MAGE-C1 (melanoma-associated antigen-C1) in breast cancer tissues and its correlation with clinicopathological features and prognosis of breast cancer patients. Methods: Breast cancer tissues, normal breast tissues and benign breast lesion tissues (60 samples for each) were collected from the Fourth Hospital of Hebei Medical University during January 2008 and December 2008.The mRNA and protein expressions of MAGE-C1 in three types of breast tissues were detected by RT-PCR and immunohistochemistry, and their correlation with clinicopathological parameters and prognosis of breast cancer patients were also analyzed. DNA methylase inhibitor 5-aza-2'-deoxycytidine (5-Aza-CdR) and histone deacetylase inhibitor trichostatin A (TSA) were used to treat breast cancer MDA-MB-231 and MCF-7 cells, and RT-PCR was used to determine the changes in mRNA expression of MAGE-C1 after drug treatment. Results: The positive expression rate of MAGE-C1 mRNA and protein in breast cancer tissues were 43.3% (26/60) and 38.3% (23/60), respectively; and the mRNA and protein expressions of MAGE-C1 were all negative in normal breast tissues and benign breast lesion tissues. MAGE-C1 expression was positively associated with high tumor grade (χ2 =6.233, P<0.05). Recurrence-free survival (RFS) of patients with negative MAGE-C1 expression was significantly longer than those patients with positive MAGE-C1 expression (χ 2 =4.213, P<0.05). MAGE-C1 expression (HR=3.980, P<0.05) and clinical stage (HR=3.637, P<0.05) could be used as independent prognostic factors for breast cancer patients. 5-Aza-CdR and/or TSA treatment had no significant influence on MAGE-C1 gene expression (P>0.05). Conclusion: MAGE-C1 is a tumor-specific antigen and its expression is associated with poor prognosis of breast cancer patients.

Reflux finding score: análisis de la concordancia inter-observador / Reflux finding score: analysis of the interobserver concordance / Reflux finding score: análise de concordância interobservador

Introducción: el reflujo laringofaríngeo (RLF) es una manifestación extradigestiva del Reflujo Gastroesofágico (RGE). Actualmente, el algoritmo diagnóstico usado en la mayoría de los Servicios de Otorrinolaringologìa (ORL) consiste en identificar los síntomas sugestivos de reflujo laringofaríngeo y realizar una fibronasolaringoscopia flexible para determinar si existen cambios estructurales identificables en la laringe o en los tejidos vecinos. Se ha desarrollado una escala subjetiva para cuantificar la severidad de los cambios inflamatorios de la laringe, identificando los hallazgos laringoscópicos asociados con reflujo laringofaríngeo. Los mismos son clasificados por el índice de hallazgos de reflujo “Reflux Finding Score” (RFS), desarrollado por Belafky y cols. El puntaje máximo es de 26 y un puntaje de 7 o mayor a 7 es considerado altamente sospechoso de RLF. Objetivos: Determinar el índice Kappa de Resultados Interobservador usando el RFS en pacientes con RLF en el Servicio de Otorrinolaringología del Sanatorio Allende. Determinar las características de los pacientes con diagnóstico de RLF según: Sexo, edad, síntomas presentes y tratamiento indicado en pacientes que consultaron ambulatoriamente en el Servicio de ORL del Sanatorio Allende sucursal Nueva Córdoba. Material y método: Se determinó el índice Kappa de Resultados entre observadores usando el RFS en paciente con RLF entre 2 médicos del staff de Servicio de ORL del Sanatorio Allende, se analizó frecuencia de sexo, edad, síntomas, conducta médica. Conclusión: El índice Kappa del RFS para cada uno de los 8 ìtems del RFS es leve, medido como < 0,2.

Introduction: the Laryngopharyngeal Reflux (LPR) is recognized as an extra-digestive manifestation of gastroesophageal reflux (GERD). At present, the diagnostic algorithm used in most of the otorhinolaryngology (ORL) services involves identifying suggestive symptoms of laryngopharyngeal reflux and carrying out a flexible fibronasolaryngoscopy to determine if there are identifiable structural changes in the larynx or neighboring tissues. A subjective scale has been developed to quantify the severity of inflammatory changes in the larynx by identifying endoscopic findings related to laryngopharyngeal reflux. These subjective findings for patients with LPR are classified using the “Reflux Finding Score” (RFS) developed by Belafsky et al.The maximum score is 26 and a score of 7 or greater is considered to indicate that LPR is highly likely. Objetive: To determine the Kappa Coefficient of the interobserver agreement using the RFS in patients with LPR in the Otorhinolaryngology Service of the Allende Hospital. To determine the characteristics of patients with LPR diagnosis according to: Gender, age, manifested symptoms and treatment indicated in patients that were treated as an outpatient in the ORL Service of the Allende Hospital, Nueva Córdoba’s branch. Material and method: The Kappa Coefficient was determined by the interobserver agreement using the RFS in patients with LPR between two Staff doctors of the ORL Service of the Allende Hospital; it was investigated the sex frequency, age, symptoms and medical behavior. Conclusions: The Kappa Coefficient of LPR for each of the eight items of LPR is poor, valued as < 0.2.

Introdução: o refluxo laringofaríngeo (RFL) é uma manifestação extra-digestiva do refluxo gastroesofágico (RGE). Atualmente o algoritmo diagnóstico usado pela maioria dos Serviços de Otorrinolaringología (ORL) consistem em identificar os sintomas sugestivos do RFL e realizar uma fibronasolaringoscopia flexível para determinar se existem mudanças estruturais identificáveis na laringe ou nos tecidos vizinhos. Existe uma escala subjetiva para quantificar a severidade das alterações inflamatórias na laringe, identificando os achados laringoscópicos que têm relação com o RFL. Eles são classificados pelo índice de achados de refluxo “Reflux Finding Score” (RFS), desenvolvido por Belafky e cols. A pontuação maxima é de 26 e uma pontuação de 7 ou maior é considerado quase sugestivo de RFL. Objetivos: Determinar o índice Kappa dos resultados interobservador usando o RFS em pacientes com RFL no Serviço de Otorrinolaringologia do Sanatorio Allende. Determinar as características dos pacientes com diagnóstico de RFL Segundo: Sexo, idade, sintomas presentes e tratamento indicado em pacientes que fizeram consultas externas no Serviço de ORL do Sanatorio Allende em Nueva Córdoba. Material e método: Determinou-se o índice Kappa dos resultados entre observadores usando o RFS em pacientes com RFL entre 2 médicos do staff do Serviço de ORL do Sanatorio Allende. Analizou-se a frequência entre o sexo, a idade, os sintomas, as doenças associadas e a terapeútica médica. Conclusões: O índice Kappa do RFS para cada item do RFS é insuficiente, medida como < 0,2.

Laryngopharyngeal Reflux and Proton Pump Inhibitors.

Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the throat that is into the hypopharynx.LPR is different from classical GERD. Although PPIs appear to be effective, higher doses for a longer duration are necessary as compared with esophageal GERD disease. In this study we focused on clinical characteristics and role of proton pump inhibitors in Laryngopharyngeal Reflux. Material and Methods: The prospective observational study was done in LPR patients in the Department of ENT and HNS of SKIMS Medical College and Government Medical College Srinagar for a period of 2 years from 2010 to 2012 .Sixty cases were enrolled in the study. LPR was diagnosed on the basis of RFS and RSI. Role of PPI was assessed by the changes of RSI and RFS with Proton pump inhibitors. Results: Total number of patients included in the study were 60, 42 (70%) cases were females, 18 (30%) were males. Frequent clearing of throat was the most common symptom. Mean RSI of all patients was 25.25 before treatment. Significant change in RSI occurred after first 10 weeks of therapy and no further significant change occurred in the next 10 weeks. Most common laryngeal finding was erythema/hyperaemia; Mean RFS of the patients was 13 before treatment with proton pump inhibitors. There was slight response after 10 weeks of therapy in physical findings and significant response after 20 weeks. Conclusion: LPR is a common condition presenting in ENT settings, the symptoms and signs may be complex. PPI are treatment of choice and should be continued for about 5 months because clinical symptoms take about two month to resolve while signs take about 5 months to resolve.

Correlation between Ambulatory 24 Hour Dual Probe pH Monitoring and Reflux Finding Score, Reflux Symptom Index in the Laryngopharyngeal Reflux / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A 24-hour ambulatory dual probe for pH monitoring is the most specific and sensitive test for laryngopharyngeal reflux (LPR) disease. However, the use of this probe is not well tolerated in some patients due to discomfort and the invasive nature of the procedure. Thus, the diagnosis of LPR is usually made according to symptomatic responses to empirical treatment using a proton-pump inhibitor for patients with high score of reflux symptom index (RSI) and reflux finding score (RFS). The aim of this study is to evaluate the relationship between the RSI and RFS and pH monitoring using a 24-hour ambulatory dual probe, and determine the role of RSI and RFS in the diagnosis of LPR. SUBJECTS AND METHOD: We studied 100 patients who underwent pH monitoring using a 24-hour dual probe because of laryngopharyngeal reflux related symptoms or laryngoscopic findings. The various parameters of the 24-hour dual probe pH monitoring were compared with the scores of RSI and RFS. RESULTS: In 24-hour dual probe pH monitoring, 64 of 100 patients tested positive for LPR. The mean of RSI score was significantly higher in the positive LPR group than in the negative group. However, RFS did not differ between the two groups. RSI scores were significantly associated with the reflux number in the upright position of the 24-hour dual probe pH monitoring. There was no correlation between RFS and the parameters of the 24-hour dual probe pH monitoring. CONCLUSION: RSI can be a reliable diagnostic tool for laryngopharyngeal reflux disease instead of the 24-hour ambulatory dual probe pH monitoring.

Treatment of Hodgkin\u2019s disease with ABVD followed by low-dose involved field of radiotherapy: analysis of efficacy

Background: Treatment of Hodgkin\u2019s disease with ABVD followed by low-dose involved field of radiotherapy is currently considered the standard of care. Objectives: This study was evaluated the efficacy and some pronogstic factors. Subjects and method: 103 consecutive patients with newly diagnosed HD\ufffd?disease treated with combination CT and RT at K-hospital between 10/2001 \ufffd?3/2005 were eligible. The end points of the study were complete response (CR), relapse-free survival (RFS), overall survival (OS). Tests were used for analysis: chi-square test, Kaplan-Meier method... Results: 103 patients (100%) achieved a CR. The RFS and OS rate at 5 years were 64,6% and 91,7%. Pronogstic factors are sex, anemia, B symtom, liver lesion. Conclusion: Treatment plan has brought the most effective so far. Liver damage is a bad influence markedly the survival time.